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A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis

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Abstract

Purpose

To evaluate outcomes following treatment of transplant renal artery stenosis by percutaneous transluminal angioplasty and stent insertion.

Materials and Methods

A literature search was performed using Pubmed, MEDLINE, Embase, Wiley Interscience and the Cochrane Library databases. Outcome measures were glomerular filtration rate, creatinine, blood pressure and number of antihypertensive medications. Technical and clinical success, patency and complication rates were also analysed.

Results

Thirty-two studies met the inclusion criteria, involving a total of 884 interventions including PTA, stenting, or combinations of both. Clinical success rates were in the range 65.5–94 %. The majority of studies reported technical success rates higher than 90 %. Patency rates were in the range of 42–100 %. However, the definition and diagnostic criteria for TRAS varied widely between studies. Also, marked heterogeneity was observed in the reporting of outcome measures with no consensus in outcome criteria or follow up schedule.

Conclusion

Outcomes following PTA and stenting for the treatment of TRAS have been shown to be favourable. However, there is a distinct lack of well designed studies assessing outcomes following intervention. Outcome reporting may be improved by the introduction of standardised outcome measures with reporting of outcomes into a multi-centre registry.

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Abbreviations

PTA:

Percutaneous transluminal angioplasty

TRAS:

Transplant renal artery stenosis

DSA:

Digital subtraction angiography

CTA:

Computed tomography angiography

MRA:

Magnestic resonance angiography

GFR:

Glomerular filtration rate

SBP:

Systolic blood pressure

DBP:

Diastolic blood pressure

MAP:

Mean arterial pressure

CMV:

Cytomegalovirus

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Conflict of interest

The authors wish to declare no disclosures or conflicts of interest.

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Authors and Affiliations

  1. Department of Interventional Radiology, St Mary’s Hospital, Praed Street, London, W2 1NY, UK

    A. T. Ngo & M. S. Hamady

  2. Department of Cancer and Surgery, St Mary’s Hospital, London, UK

    S. R. Markar

  3. Department of Radiology, Academic Medical Centre, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands

    M. S. De Lijster

  4. Imperial College Kidney and Transplant Centre, Hammersmith Hospital, London, UK

    N. Duncan & D. Taube

Authors
  1. A. T. Ngo
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  2. S. R. Markar
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  3. M. S. De Lijster
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  4. N. Duncan
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  5. D. Taube
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  6. M. S. Hamady
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Correspondence to A. T. Ngo.

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Ngo, A.T., Markar, S.R., De Lijster, M.S. et al. A Systematic Review of Outcomes Following Percutaneous Transluminal Angioplasty and Stenting in the Treatment of Transplant Renal Artery Stenosis. Cardiovasc Intervent Radiol 38, 1573–1588 (2015). https://doi.org/10.1007/s00270-015-1134-z

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  • DOI: https://doi.org/10.1007/s00270-015-1134-z

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